A Pyloroplasty is an additional surgery that is sometimes performed in conjunction with G-tube placement or a Nissen fundoplication. In some cases, it may also be done as a stand-alone procedure.
The pylorus is the valve between the stomach and the small intestine. In some children, the pylorus does not open easily, spasms, or has thickened. This can block stomach contents from flowing into the intestine. Children may vomit, reflux, or have delayed gastric emptying. In some cases, there may be little to no movement of stomach contents into the intestine, which is called gastroparesis.
Surgeons may widen the pylorus surgically, called a Pyloroplasty, in order to help the stomach empty more readily. While this procedure is usually performed with an open incision in the abdomen, it can also be performed laproscopically. Typically, children are placed under general anesthesia. When the surgery is performed as a stand-alone procedure, pain is usual moderate after the procedure, and children rarely need more than 1-2 days in the hospital. If it is performed in conjunction with other surgical procedures, pain may be more significant, and the hospital stay may be longer.
Risks and Complications
There are risks to Pyloroplasty surgery. The most common complication is that feeds pass too quickly into the small intestine, which may cause a condition called Dumping Syndrome. Bile may also reflux upwards into the stomach.
An alternative to Pyloroplasty surgery is to try Botox injections into the pylorus, usually during an endoscopy. These injections cause the pylorus to relax and loosen. Botox typically only lasts for 1-3 months, so the procedure may need to be repeated again. Often, a trial of Botox can help a doctor or surgeon predict the success of a Pylorplasty, so Botox may be tried first.
Rarely, young infants aged about 6-12 weeks may develop a condition called Pyloric Stenosis, which causes the pylorus to thicken. This is a life-threatening emergency. If a baby suddenly stops tolerating feedings and is vomiting continuously, take him or her to the emergency room immediately. The baby will likely require a similar surgery to a Pyloroplasty, typically called a Pyloromyotomy, in which the pylorus is cut vertically.